Aims: To examine whether women’s attitudes, women’s motivation, and women’s role in household practices predict the KRS program performance score among At-Risk Families (Keluarga Berisiko Stunting; KRS) and to identify the most robust predictor in multivariable analysis. Study Design: Quantitative analytical cross-sectional survey. Place and Duration of Study: Special Region of Yogyakarta, Indonesia (Sleman District, Bantul District, and Yogyakarta City), during the study period. Methodology: The target population comprised KRS households (sampling frame: 68,219). Using proportional stratified random sampling by administrative area, 200 households were selected. Enumerators administered a structured questionnaire, and responses were consolidated into composite scores for the KRS program performance score (household involvement/adherence to KRS-aligned stunting-prevention activities) and three predictors: women’s attitude, women’s motivation, and women’s role (covering domestic responsibilities including maternal childcare and household management relevant to child nutrition and health). Multiple linear regression with SPSS Backward elimination was applied (F-to-remove probability ≥ 0.100). Assumption checks included residual normality and homoscedasticity using plots, and multicollinearity using tolerance and variance inflation factor (VIF). Results: The primary regression used complete cases (n = 191). In the final model, women’s attitude was the only significant predictor of the KRS program performance score (B = 2.522; standardized β = 0.560; p < 0.001), explaining 31.4% of the variance (R² = 0.314; F = 86.340; p < 0.001). Women’s motivation (p = 0.197) and women’s role (p = 0.421) were removed during backward selection. Multicollinearity was not indicated (VIF 1.675–1.937). Conclusion: In this sample of KRS households in Yogyakarta, women’s attitude was the most significant predictor of household program performance. Stunting-prevention strategies should prioritize attitude-strengthening components that translate endorsement into timely routine actions, while concurrently addressing enabling conditions beyond personal factors.

Do social skills improve healthcare data quality? A cross-sectional study in eight referral hospitals.

Social screening initiatives often prioritize identifying social risks before offering support. The extent to which the emphasis on social risks contribute to overscreening and/or underdetection of needs, overall and across demographic subgroups, remains underexplored. To examine the agreement between self-reported social risks and needs for support and variance in risk-need concordance across racial, ethnic, and sex subgroups. This cross-sectional study examined responses to an online or mailed survey fielded between March 2 and May 9, 2023, to Veterans Health Administration patients who visited their primary care practitioner in January or February 2023. Survey weights were used to adjust for sampling frame and nonresponse. The data were analyzed between April 6 and December 15, 2025. Intersection of race, ethnicity, and sex. Risk-need sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and concordance across 12 domains (paying for basics, obtaining adult caregiving, obtaining childcare, finding or keeping work, paying for food, finding or keeping housing, getting transportation, accessing the internet at home, feeling isolated, feeling lonely, getting legal assistance, and getting additional education or job training) were measured using age-adjusted relative risk ratios (ARRRs) of risk-need discordance (vs concordance), controlling for a family-wise error rate of .05. The analytic sample included 6596 respondents, representing 937 003 veterans after weighting (unweighted number [weighted percentage]: aged <65 years, 2992 [48.5%]; aged ≥65 years, 3604 [51.5%]; 1088 identifying as Black female [4.1%], 1140 as Black male [19.4%], 939 as Hispanic female [1.6%], 1279 as Hispanic male [11.3%], 802 as White female [5.3%], and 1348 as White male [58.4%] race or ethnicity and sex). Across domains, risk-need sensitivity ranged from 42% (95% CI, 34%-49%) for housing to 99% (95% CI, 98%-99%) for loneliness, and specificity ranged from 69% (95% CI, 66%-71%) for loneliness to 98% (95% CI, 97%-99%) for childcare. The PPV ranged from 27% (95% CI, 22%-33%) for housing to 69% (95% CI, 63%-75%) for legal issues, and NPV ranged from 93% (95% CI, 91%-94%) for housing to 99% (95% CI, 99%-99%) for both childcare and loneliness. In age-adjusted models, compared with White male veterans, Black male veterans had a significantly higher likelihood of need-without-risk discordance for paying for basics (ARRR, 3.95; 95% CI, 1.80-8.64), housing (ARRR, 2.67; 95% CI, 1.59-4.48), and adult caregiving (ARRR, 2.13; 95% CI, 1.30-3.48). Additionally, compared with White male veterans, the likelihood of need-without-risk discordance for loneliness was higher among White female (ARRR, 14.02; 95% CI, 2.85-68.95), Hispanic female (ARRR, 10.87; 95% CI 2.31-51.25), and Hispanic male (ARRR, 8.08; 95% CI, 2.47-26.39) veterans. Differences for risk-without-need discordance were not significant. This cross-sectional study of Veterans Health Administration patients found that social risk questions were better at identifying veterans without a social need than those who needed support and underdetected need for support among Black male veterans. Improved survey methods are essential to accurately detect needs in diverse populations.

Exploration of the prevalence and production impact of Mycobacterium avium subsp. paratuberculosis (MAP) infection in the sheep populations of Great Britain and New Zealand.

Banana production as a food crop component cannot be underestimated. Bananas are currently ranked fourth among foods produced worldwide. The study aimed to investigate the effects of logistics management practices on post-harvest loss among small-scale banana farmers in selected counties in Kenya. The study used a cross-sectional research design. The target populations were small- scale banana farmers from three selected banana-producing counties in Kenya. The study's sampling frame was a list of 14,447 farmers from three selected counties. The researcher stratified the counties and used a table of random numbers to pick farmers. Data were collected using a semi-structured questionnaire. Descriptive and inferential statistics were used to analyze the data in SPSS. The findings reveal a significant negative relationship between logistics management practices and post-harvest losses among small-scale banana farmers (β = -0.536, p = 0.000). The study concludes that effective logistics management can significantly reduce post-harvest losses. The study recommends that small-scale banana farmers focus on efficient transportation methods and consider traditional technologies. County governments need to train banana farmers on best practices for handling bananas to prevent damage during harvest and post-harvest stages.

Introduction: The Council of Academic Family Medicine (CAFM) Educational Research Alliance (CERA) provides infrastructure and a streamlined process for multi-institutional educational research surveys within academic family medicine. This report outlines the methodology of the 2025 CERA Department Chair Survey, compares the demographics between actual and potential department chair survey respondents, and provides a summary of previous survey topics. Methods: CERA issued a call for survey proposals from March 24, 2025 to May 4, 2025. Four proposals were accepted and questions were reviewed by five former department chairs. The omnibus survey combined the proposed question modules with standardized recurring demographic measures. We defined the sampling frame as all family medicine department chairs in the United States and Canada of Liaison Committee on Medical Education (LCME)-accredited medical schools as identified from CAFM member databases and prior CERA survey responses. The survey was conducted through SurveyMonkey from August 5, 2025 through September 15, 2025. We used Fisher's exact tests to compare demographics potential and actual survey respondents. Results: Of 210 eligible department chairs, 97 received and completed the survey, yielding a 45.7% response rate. Comparison of potential and actual survey respondent demographics showed no statistically significant differences by race/ethnicity, gender, age, or geographic location. Conclusions: The 2025 CERA Department Chair Survey achieved an acceptable response rate, and sample respondents were representative of the potential population. The methods described can inform future multi-institutional educational surveys seeking engaged participation and representative samples.

The study examined the moderating effect of reflective action team learning practices on the association between team psychological safety and knowledge acquisition and creation in teaching hospitals. The study population comprised trainees and health professional staff teams. Using a cross-sectional survey design and sampling frame of teaching hospitals, a sample of 132 respondents was selected. Statistical Package for Social Scientists (SPSS) with a PROCESS macro procedure by Hayes was used for data analysis. Results indicated that reflective action team learning moderates the relationship between team psychological safety and knowledge acquisition. There was a statistically significant regression of team psychological safety and knowledge creation. The interaction effect between team psychological safety and reflective action team learning was significant. Thus, nurturing reflection-in-action team learning practice has high ramifications for knowledge acquisition and creation, which are prerequisites for clinical evidence-based practices

Several systematic and scoping reviews have focused on the impact of patient and public involvement (PPI) in child health research. The aim of this research was to examine the data sources and analytic approaches used by researchers to evaluate the impact of PPI in child health research. A comprehensive literature search identified published reviews focused on PPI impact in child health research. Titles, abstracts, and full texts were screened to determine eligibility. Individual studies from eligible reviews created the sampling frame, from which 100 individual studies were randomly selected. Information was extracted on primary study characteristics, type of PPI, data sources and analytic approaches used to evaluate PPI impact, and reported PPI impact. Frequency distributions were used to summarise the findings. The initial search yielded 5868 citations. After screening, 15 reviews (comprising 406 individual studies, of which 303 were unique) met inclusion criteria. Among the 100 randomly selected individual studies, PPI was reported across all phases of the research process including priority setting (30/100), input on study materials (50/100), and dissemination of study findings (52/100). The method of PPI was most commonly focus groups (29/100) or advisory committees (27/100). Of the 100 studies selected, 67/100 reported impact on the research process, 69/100 reported impact on patients and families, and 32/100 studies reported impact on researchers. Regarding the data sources used to evaluate PPI impact, 69/100 studies reviewed primary study field notes along with researcher observations and reflections, while 31/100 studies conducted independent, specific, focus groups and/or interviews and/or surveys to gather data. Regarding the analytic approaches used to evaluate PPI impact, formal qualitative and/or quantitative analyses of the data occurred in only 25/100 studies. Only 2/100 studies used a formal PPI reporting guideline. Only 31/100 studies collected specific, independent data on the impact of PPI in child health research, and only 25/100 studies applied formal analyses. Robust evaluation of PPI impact in child health research is essential for a strong PPI evidence base. A patient partner (co-author, FB) was a member of the research team from study inception, and contributed to the development of the study protocol, including refining the research question, input on study design, selection of relevant outcomes, interpretation of findings, writing the manuscript, and developing dissemination plans.

Nigeria produced a lot of cassava. The purpose of this study was to assess the adoption of cassava production technologies by farmers in Bomadi, Nigeria. Specifically, it identified cassava production technologies, ascertained the level of adoption and examines factors affecting adoption of technologies. Study design was a survey and purposive and random sampling techniques were used to select twenty farmers each from a sample frame consisting of twenty-five farmers each in nine communities making a total of one hundred and eighty (180) respondents. Primary data obtained were analyzed using simple frequency and percentage. The results reveal that majority (71.10%) of the respondents were female, aged 50 years (41%), having no formal education (31.10%), and 100.0% of the respondents used less than 1ha of land for cultivation. On income level, 62.20% had income level of less than N20, 000 per annum, and 82.2% adopted sole cropping but there was no extension visitation as inadequate extension staff was 94.44%. The result further reveal that age, educational background and extension services affect adoption of technologies. The Practical implication is that age, education and extension service greatly influence the number of technologies adopted by farmers. The theoretical implication shows that it was an attempt to understand the adoption decisions of individual farmers and the diffusion patterns among communities of farmers. The paper provides evidence of the adoption behaviour of farmers and shows whether the factors responsible for the behaviour are consistent with adoption theory. It also provides insights into similar research in other areas of adoption. It is therefore recommended that adequate attention should be paid to age, education and provision of agricultural extension service when introducing technologies for adoption by farmers.

Fish screens are a sustainable agricultural innovation that offers economic and environmental benefits by protecting aquatic life and enhancing the efficiency of irrigation. In freshwater irrigation ecosystems, fish screens help protect aquatic organisms by reducing fish entrainment, facilitating ecological connectivity, and lowering mortality at early life stages. Therefore, they contribute significantly to aquatic biodiversity conservation. However, the role of trust in media in influencing Australian irrigators’ intentions to use fish screens remains underexplored. The study, guided by the Elaboration Likelihood Model (ELM) and incorporating the Theory of Consumption Values, examines trust in media as a persuasive factor impacting the functional, environmental, and Interpersonal Trust Cue of fish screens. The irrigators’ willingness to test, adopt, or implement fish screens can also predict the irrigators’ readiness to act for biodiversity-relevant outcomes. Data were collected between December 2021 and May 2023 from 192 Australian irrigators (sampling frame = 3736; response rate = 5.1%). The PLS-SEM results reveal that trust in media significantly predicts adoption intention (β = 0.134, 95% CI [0.021, 0.246]) and resource (time) efficacy (β = 0.170, 95% CI [0.054, 0.289]), with resource efficacy partially mediating this relationship. The study offers a theoretical contribution by integrating the ELM, the Theory of Consumption Value, and resource efficacy to explain how trust in media influences adoption through different persuasive routes. The model explains 22.5% of the variance in adoption intention. The findings indicate that resource efficacy is a critical enabling factor in translating conservation-oriented communication into an effective measure to protect freshwater biodiversity.

South Africa bears a high burden of infectious diseases, including intersecting epidemics of human immunodeficiency virus (HIV) and tuberculosis (TB). Among people living with HIV, TB is the predominant cause of death. Since 2002, South Africa has conducted six national population-based HIV surveys, and its first national TB prevalence survey between 2017 and 2019. Given the epidemiologic overlap of these conditions and dwindling resources, a joint national TB and HIV survey could be advantageous. We piloted a joint survey design in August–September 2019 to assess the feasibility of simultaneously collecting HIV and TB data. The pilot survey utilized the same sampling frame as the 2017–2019 national TB prevalence survey, based on small area layers as building blocks for clusters. Two clusters in KwaZulu-Natal (one urban and one rural) were selected. People of all ages were eligible to participate. Household questionnaires were administered to consenting household heads, followed by invitations to the cluster survey hub, where age-appropriate individual questionnaires were administered. Whole blood samples were tested for HIV, viral load, HIV drug resistance and HIV recent infection status. TB metrics included symptom and chest x-ray screening with sputum testing for those screening positive. Those ≥18 years received other health measurements (weight, height) and screening tests (random blood glucose, cholesterol). The survey successfully combined the collection of both HIV and TB relevant data. Overall, Household-level uptake was 78.6% (363/462), while individual-level uptake at the hub was 48.1% (616/1,280), with lower participation in the urban cluster. Uptake of additional health measurements exceeded 87%. The pilot study demonstrated that combining TB and HIV surveys is possible, but fewer people participated compared to the individual national HIV and TB surveys. Further operational research could explore how to optimize survey design, accommodate differing data requirements, and improve participation in future joint surveys.

This study examines how gender norms are expressed and negotiated in WeChat Public Accounts using Feminist Critical Discourse Analysis (FCDA). We built a sampling frame of the ten most active gender-related accounts (June–December 2023) and screened 359 posts for relevance and analyzability. Twenty-two articles were selected for close reading. Two researchers independently coded clause- and sentence-level segments and reached agreement through discussion. Coding followed six dimensions used throughout the paper: lexical choice, modality, intertextuality, voice positioning, affective tone, and strategic silence. Four recurring themes were identified. (1) Maternal discourse and gendered discipline: texts often link women’s value to motherhood and domestic duties, combining moral language with advice on correct behavior. (2) The body and mechanisms of shame: discussions of menstruation and sexuality frequently use medical or corrective language that assigns responsibility to individual women. (3) Gender identity in cultural, legal, and policy narratives: educational, media, and policy-adjacent texts describe ideal feminine roles through procedure, quantification, and role models, which stabilize familiar expectations. (4) Resistant discourses and incremental change: some pieces re-label practices, shift speaking positions, or use humor to push back against these norms. Overall, the analysis shows how everyday textual choices can normalize gendered expectations, while limited forms of resistance also appear. The findings are bounded by the small, purposive sample and the focus on text rather than audiences or algorithms. The study provides a transparent description of patterns observed in the 22 articles and clarifies where and how resistance is articulated within them.

Type of the article: Research ArticleAbstractE-commerce has become one of Vietnam’s most dynamic and fastest-growing sectors, reshaping consumer purchasing behavior in the digital economy. This study investigates the key determinants of consumers’ trust and its mediating role in online purchase decisions in Vietnam. Primary data were collected through an online survey of 419 Vietnamese consumers who had made at least one purchase on major e-commerce platforms (e.g., Shopee, TikTok, Facebook) during the previous six months. This sampling frame ensured that all respondents had recent and relevant experience with online shopping in Vietnam’s e-commerce market. Data were collected between October 2024 and August 2025 using a structured questionnaire and analyzed with PLS-SEM in SmartPLS 4.1. The findings reveal that website quality (β = 0.235, p &amp;amp;lt; 0.01), reference groups (β = 0.209, p &amp;amp;lt; 0.01), perceived service quality (β = 0.184, p &amp;amp;lt; 0.01), and information security (β = 0.171, p &amp;amp;lt; 0.01) significantly enhance Vietnamese consumers’ trust in online shopping. Suppliers’ reputation (β = 0.106, p &amp;amp;lt; 0.01) and suppliers’ size (β = 0.067, p &amp;amp;lt; 0.01) indirectly strengthen consumers’ trust through website quality and perceived service quality, respectively. The study further confirms that trust serves as an essential mediating construct, meaningfully strengthening online purchase decisions among Vietnamese consumers (β = 0.608, p &amp;amp;lt; 0.01). These findings underscore the central importance of trust in shaping consumer behavior in emerging e-commerce markets, indicating that enhancing website quality, improving service reliability, and strengthening data protection can contribute to more sustainable online purchasing behavior among Vietnamese consumers.AcknowledgmentsThe authors received no financial support or external funding for conducting this research or preparing the manuscript. All analyses and interpretations were carried out independently by the authors.

Background: Maternal health, encompassing pregnancy, childbirth, and the postpartum, is a key indicator of public health but remains a challenge in low- and middle-income countries due to limited skilled care, poor nutrition, and low service uptake. Maternal health services can reach many women, yet limited studies exist on the impact of digitisation on maternal health outcomes. This study assessed the utilisation of an electronic community health information system (eCHIS) in enhancing the adoption of maternal health services in Muhoroni Sub-County, Kisumu County, Kenya. Methodology: This study utilised a cross-sectional descriptive design, using a structured questionnaire to collect quantitative data from 398 lactating mothers with children younger than six months. Participants were selected by simple random sampling from a sampling frame drawn from eCHIS data across villages in Muhoroni Sub-County. Analysis was performed using SPSS, with linear regression applied to examine variable relationships. Results: eCHIS use showed a positive, significant relationship with maternal health service adoption (p = 0.001). The R² of 0.656 indicated eCHIS explained 65.6% of the variation, with the remaining 34.4% variance linked to confounders such as cultural beliefs, spousal support, accessibility, and power outages. The Smart Health App, used by Community Health Promoters (CHPs), improved service access and utilisation by 18.4%. Conclusion: The findings highlighted eCHIS as a transformative tool in improving maternal health outcomes, particularly in marginalised areas. The adoption of eCHIS by CHPs represents a critical step in Kenya's efforts to reduce maternal complications and advance maternal health equity. Recommendation: The study recommended that the Department of Health strengthen monitoring of eCHIS to improve maternal health service delivery, implement educational programs to raise community awareness and informed decision-making, and enhance health facility services to encourage care-seeking and meet the rising demand created by eCHIS.

The measles vaccine represents one of the most efficacious means of safeguarding pediatric populations against the measles virus. Empirical evidence consistently demonstrates that over 99% of recipients who complete the two-dose regimen achieve immunity to the disease. Despite this high efficacy, suboptimal vaccine coverage persists as a significant impediment to the containment and eventual eradication of measles. To augment immunization coverage, routine vaccination programs are often supplemented by second-dose opportunities administered through Supplemental Immunization Activities (SIAs), particularly in countries with a high measles burden. This study aims to evaluate the measles vaccination coverage attained after the nationwide SIAs in May 2025 as well as vaccination coverage prior to SIAs. This study was conducted from May 26th to June 5th, 2025. A two-stage cluster sampling design was utilized, where 938 clusters were randomly selected from a national sampling frame of 6,936. This sampling frame covered all accessible districts, villages, and nomadic areas throughout the country. The sample size was calculated using the WHO-2018 manual, resulting in the selection of 134 clusters and 1,780 households from each state, culminating in 12,832 interviews overall. A total of 355 interviewers, equipped with the KoboCollect app for digital data collection, conducted surveys. We calculated vaccine coverage during supplemental immunization activities (SIAs) and prior to SIAs (which means routine immunization). To calculate the national coverage, a survey weighting methodology was applied. Specific procedures were used to determine cluster and household weights, following the formula outlined in the WHO Vaccination Coverage Cluster Survey 2018. Both descriptive and inferential statistics were applied. Descriptive statistics, including frequency counts and proportions, enabled us to summarize the general attributes of the sample. Conversely, inferential statistics were used to estimate national vaccine coverage, featuring point estimates and confidence intervals (Wilson 95% Confidence Intervals), with the application of survey weights. Ethical approval was obtained from the Somali National University Ethical Committee. Of 17,700 children across seven states, 46.5% were girls and 53.5% were boys. Most children (56.2%) lived in urban areas, followed by 25.8% in rural areas and 14.2% in nomadic areas. Additionally, 3.76% of children lived in Internally Displaced Persons (IDP) camps. Weighted coverage estimates indicate that 73% (CI: 68.14-77.3) of children in Somalia received the measles vaccine during SIAs. Regarding the regional variation of vaccine coverage, the highest coverage was observed in Somaliland (87.4%, CI: 81,7-91.3) and Puntland (87.1%, CI: 82.7-90.5), while the lowest were found in Hirshabelle (48%, CI: 32.6-63.8) and Southwest (50%, CI: 40.4-59.7) states. In terms of geographic settlements, the nomadic population had the lowest measles vaccine coverage during SIAs (70.9%, CI: 57.8-81.3), and had the highest zero-dose children of 15.4% (CI: 8.9-25.2) compared to urban and rural populations. The national measles coverage prior to SIA was found to be 78,6% (CI: 74.6-82.09). The SIAs achieved a national coverage rate of 39.8% among children who had previously received no doses (zero-dose children) and 82% among those who had received at least one dose prior. The predominant reason for children not being vaccinated during the SIAs was a lack of awareness about the vaccination campaign. The lowest national vaccine coverage and the highest proportion of zero-dose children were predominantly found in the Hirshabelle and Southwest states and among nomadic communities. This difference in vaccine coverage among states and communities is concerning and suggests the need for targeted intervention to address these gaps.

The role of social media in developing youth identity, self-representation, and cross-cultural interactions is highly significant, especially for users of diverse backgrounds. The goal of this research project was to investigate the influence of cultural context – specifically China, the USA, and the UK – on active social media users aged 15-24 in relation to self-representation practices, self-exposure behaviors, privacy management, and identity negotiation strategies. The participants were recruited through a stratified purposive sampling frame and required to have updated or posted on their social media profile in the previous three months. The study collected a total of 450 valid responses using online surveys (Google Forms for the USA and the UK, and Wenjuanxing for China). The data analysis consisted of descriptive statistics, correlation analysis, and Multiple Linear Regression (MLR). Participants had a balanced demographic distribution across age groups, gender, and countries. The findings reported moderate agreement (across behavioral measures) and weak correlations across variables, indicating that each dimension operates relatively independently of the others. Differences in preferences for platforms, with Facebook preferred most (22.2%) and TikTok/Douyin second (20.2%); WeChat was the lowest (17.8%). Daily usage indicated 26.9% spend less than 1 hour and 23.1% spend more than 4 hours each day online. The findings begin to expose differences in practice in relation to cultural differences in online identity practices. The findings also affirm that valuing culturally responsive processes is meaningful.

Consideration needs to be given to such issues as short versus long term performance, risk taking versus risk aversion, division performance versus total corporate performance, maximization versus sales growth and so on. The best designed reward system can often go awry in producing the intended results because poor implementation. Rewards succeed at securing only in securing one thing, that is a temporary compliance. The study seeks to examine effectiveness of organisational rewarding system for employee performance. This is a case study of the national health insurance management authority. This academic study adopted a case study design. The population of interest in this study will consist of the staff from NHIMA. Sampling is the act, process or technique of selecting a suitable sample or a representative part of a population for the determining parameters or characteristics of the whole population. A sampling frame is a list, directory or index of cases, that enables realization of a representative sample. This academic study adopted the non- probability sampling technique to select the 50 respondents. Specifically, the purposive sampling techniques that was employed with a view of getting samples that are as representative as possible. The analysis of responses regarding the use of promotions as a reward for high-performing staff reveals distinct patterns across departments within NHIMA. The IT department demonstrated the highest level of agreement, with 100% of respondents either agreeing (33.3%) or strongly agreeing (66.7%). Similarly, in the Admin department, all participants (100%) agreed that promotions are used as a reward system. In contrast, the Claims department reflected a high degree of uncertainty, with 80% of respondents remaining neutral. Only 5% agreed. The Finance department showed unanimous disagreement, with 100% of respondents expressing disagreement, suggesting an absence of promotions as a performance-based reward in this unit. Likewise, in the HR department, 50% strongly disagreed and 50% disagreed. The statistical test results reinforce these findings. The Pearson Chi-Square value of 125.481 with a p-value of .000 indicates a statistically significant association between department and perception of promotions as a reward.). (Coefficients) further reveals that among the four predictors, training content relevance to actual job and reward process had the strongest and statistically significant effect on improved employee performance (β = 0.907, p &lt; 0.001).Conversely, other predictors - including understanding reward criteria (p = 0.555), explanation of rewards-performance linkage (p = 0.146), and increased motivation to work for rewards (p = 0.184) - did not show statistically significant contributions to performance enhancement in this model. Residual statistics (Table 3) show a low standard deviation of 0.177 in residuals and a near-zero mean, supporting the model’s robustness and the suitability of the predictors. The study recommends that there is a need to harmonize on packages that will be appreciated by staff and thus enhance performance. There is also a need to train staff in HR so as to increase knowledge on rewarding systems.

Quantum tourism is an emerging phenomenon that integrates traditional tourism experiences with advanced technological, cultural, and spiritual dimensions. This study aims to explore the application of quantum tourism in Bali, analyzing how cultural and spiritual elements, alongside emerging technologies, can be synergized to enhance the tourism experience. The research employs a mixed method approach, where qualitative approach using interviews, data from previous studies, and quantitative approach using surveys with key stakeholders in Bali’s tourism industry. Combination of survey modes used were directed to the available sample frame. The findings enhance the conceptual understanding of quantum tourism by highlighting the quantum technology and central role of Bali’s spiritual energy, taksu, in shaping tourist experiences. However, the study also reveals the underutilization of advanced technologies such as IoT and AI. Findings suggest that, in times of uncertainty, investing in quantum technologies and sustainable practices could bolster Bali’s hotel, travel and tourism industry, ensuring it remains competitive and culturally authentic.

Background: Computerized Provider Order Entry (CPOE) systems are critical for medication safety, but their effectiveness relies heavily on the completeness of entered data. Incomplete clinical and anthropometric information can disable Clinical Decision Support Systems (CDSSs), compromising patient safety. Objective: This study aimed to assess the longitudinal evolution of CPOE data completeness, specifically focusing on "Breadth Completeness" (the presence of essential clinical variables), and to identify factors predicting data integrity in a tertiary care setting. Methods: A retrospective cross-sectional study was conducted at a 500-bed tertiary referral center in Riyadh. Data were extracted from the Cerner Millennium CPOE system for three "steady-state" years (2015, 2017, and 2019); years involving major system overhauls (2016 and 2018) were excluded to avoid structural bias. A total of 600 unique patient encounters (200 per year) were selected using systematic random sampling from a chronologically ordered sampling frame to minimize temporal bias. The primary outcome was "Breadth Completeness," defined as the presence of eight key variables: age, gender, marital status, weight, height, diagnosis, vital signs, and allergies. Secondary outcomes included documentation consistency (daily notes). Multivariable logistic regression, adjusted for potential confounders, was used to determine predictors of completeness. Results: The rate of primary data completeness (Breadth) improved significantly over the study period, rising from 5.5% in 2015 to 26% in 2017 and 49.5% in 2019. In the multivariable analysis, the year of documentation (OR = 17.47 for 2019 vs. 2015, p < 0.0001) and length of hospitalization (OR = 1.04, p = 0.045) were significant predictors of completeness. Pharmacist-led medication reconciliation was associated with a 2.5-fold increase in data completeness in bivariate analysis (p < 0.0001). Conclusions: While system maturity has driven substantial improvements in CPOE documentation, critical gaps persist, particularly in anthropometric data required for safety alerts. The study underscores the necessity of mandating "hard stops" for core variables and formalizing pharmacist involvement in data reconciliation to ensure patient safety.

Introduction: Exclusive breastfeeding during the first six months of life is critical for infant health. Despite the national and international promotions and guidelines, the rate remains subpar. Objective: To estimate the prevalence of exclusive breastfeeding and determine the factors of exclusive breastfeeding in the Damak municipality of Jhapa. Materials and Methods: A cross-sectional study was conducted among 388 mothers using a structured questionnaire. The sampling frame was constructed using vaccine records. Data were analyzed using the concept of descriptive statistics, chi-square, and Mann-Whitney U tests for bivariate analysis and binary logistic regression for multivariate analysis. Model diagnostics included Hosmer-Lemeshow test, Analysis of Deviance, Generalized Variance Inflation Factor, AUC and pseudo-R2. Reasons for early cessation of breastfeeding were asked to non-EBF mothers. Results: The EBF prevalence was 32.99% (95% CI: 28.31%-37.67%). Logistic regression identified initiation of breastfeeding (within an hour) (AOR=3.32, 95% CI: 1.8-6.88, p&lt;0.001), maternal knowledge (AOR=1.95, 95% CI: 1.03-3.73, p=0.04), maternal age 35-44 years (AOR=0.37, 95% CI: 0.15-0.84, p=0.021), job/wage income (AOR=2.18, 95% CI: 1.17-4.06, p=0.014) and infant age 4 months (AOR=0.40, 95% CI: 0.17-0.91, p=0.033) and 5 months (AOR=0.29, 95% CI: 0.12-0.68, p=0.005) as significant predictors. Attitude and morbidity were not statistically significant. Perceived milk insufficiency (72.85%) and perceived infant thirst (28.05%) are major leading causes of early supplementation. Conclusion: EBF in Damak is significantly below the national average. Key determinants include initiation of breastfeeding, knowledge, major income source, mother’s age and infant age in months. While attitude and morbidity were positively related, but it was not statistically significant. Lastly, 76% of the mothers had poor knowledge which highlights the knowledge gaps that affecting exclusive breastfeeding practice.